title: Sunbed use, attitudes, and knowledge after the under-18s ban: a school-based survey of adolescents aged 15 to 17 years in Sandwell, United Kingdom.
abstract: BACKGROUND
  Sunbed use in childhood increases risk of melanoma. The under-18s sunbed ban was introduced in England, April 2011. Impact on use has not been investigated since. This cross-sectional study estimates the prevalence of under-18s' use in Sandwell after the commercial ban and identifies factors associated with use/intention.
  
  
  METHODS
  Adolescents aged 15 to 17 years in schools were surveyed using self-completed anonymous questionnaires. Data collected include demographics, sunbed use, tanning attitudes, knowledge of risks and ban awareness. All Sandwell schools were approached; adolescents available on the survey days were included.
  
  
  RESULTS
  Five out of 22 schools participated, 407 adolescents responded (95.1%). Twenty participants (5.3%; 95% confidence interval [CI] = 3.4-8.0) had used sunbeds, of who 16 reported use in commercial settings. After exclusion of one school cohort with atypical use (possibly associated with beauty vocational course and European migrants), the prevalence of use was 1.7% (95% CI = 0.7-3.9, n = 5). Less than half of all were aware of the ban (48.2%; 95% CI = 43.2-53.3). Users/potential users were less aware of associated risks. Being female, having family/friends who use sunbeds increased use/intention 2- to 4-fold.
  
  
  CONCLUSIONS
  Strategies targeting parents, stricter enforcement, and greater publicity of the ban are needed. Further research exploring the possible association between certain vocational courses, migrants, and sunbed use is required.
authors.affiliation: University of Birmingham, Edgbaston, UK.
authors.forename: Siang Ing
authors.initials: SI
authors.lastname: Lee
authors.forename: Alexis
authors.initials: A
authors.lastname: Macherianakis
authors.forename: Lesley Martine
authors.initials: LM
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D001364:Awareness; D001505:Beauty Culture; D003430:Cross-Sectional Studies; D003469:Culture; D003625:Data Collection; D005190:Family; D005260:Female; D033062:Friends; D033161:Government Regulation; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008545:Melanoma / Q000209:etiology / Q000517:prevention & control; D012306:Risk; D012309:Risk-Taking; D012574:Schools; D012737:Sex Factors; D055108:Sunbathing / Q000331:legislation & jurisprudence; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: adolescent; ban; knowledge; school; sunbed use